Psychiatrische Praxis
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Psychiatrische Praxis · Jul 1994
Review[Confusional states in advanced age--a current review of the literature].
Delirium--a state of acute or subacute confusion--is a common organic mental syndrome occurring predominantly in old age. The disorder is highly prevalent in psychiatric institutions, in general hospitals and nursing homes. Patients affected by delirium carry an increased mortality-risk and will become dependent on nursing care in a high percentage. ⋯ A review of recent publications indicates that substantial advances in knowledge on epidemiology, operationalized diagnosis, risk factors, and course of delirium have been attained. There are, however, important aspects--e.g. the evaluation of prophylactic and therapeutic measures--which have been neglected. With regard to the high prevalence of delirium and the inderdisciplinary relevance of this syndrome scientific activities on this field should be increased as well as refreshment of knowledge of medical and nursing staff should be aimed at.
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Psychiatrische Praxis · Jul 1994
Case Reports[Depression and benzodiazepine dependence in the elderly. On the complexity of psychiatric manifestations and psychiatric treatment].
The example of a 70 year old female patient with endogenous depression and benzodiazepine dependency at the same time shows the problems created by the attempt to attribute the clinical picture to only one singular cause. As in the beginning we were not aware of her benzodiazepine dependency, she underwent withdrawal, so that the clinical picture became very complex and lengthy; it should be considered that long-term benzodiazepine use as well as withdrawal might have contributed to genesis, at least to manifestation of the depressive disorder. Apart from the self-contained depressive disorder and benzodiazepine dependency, obviously biographic-psychodynamic and family-dynamic factors have been important in formation, but as well in remittence of the complex clinical picture. An impressive urinary retention without detectable organic origin which persisted for several weeks is remarkable.